Charge entry & claim submission
Clean claims sent on time, every day.
- Daily submission and reconciliation
- CPT and diagnosis code review
- Claim status tracking
Medical Billing & RCM
A dedicated billing team for your practice, from charge entry and prior authorization to denials, appeals and aged AR recovery. We work inside your billing system, during U.S. business hours, and report to you every month.
- to submit claims
- 2 business days
- to work new denials
- 3 business days
- from signed agreement to go-live
- 5 weeks
Where revenue slips away
Claims sit unsent, denials go unworked, and old balances age past filing limits. We close those gaps with a set routine and a named team.
- The gap
Charges sit before they are billed
Every day of charge lag delays payment and shortens the window to fix problems.
What we doDaily claim submission
Claims go out within 2 business days, reconciled daily.
- The gap
Denials pile up unworked
Denied claims that are not corrected or appealed become write-offs.
What we doDenial follow-up and appeals
New denials worked within 3 business days, with root causes tracked.
- The gap
High-dollar claims age out
Old balances, underpayments and documentation gaps miss payer deadlines.
What we doAged AR recovery
We prioritize the largest balances and track every filing and appeal deadline.
- The gap
Coverage problems found after the visit
Eligibility and authorization issues surface only when the claim is denied.
What we doEligibility and prior auth up front
Daily eligibility checks on your schedule and tracked authorizations.
- The gap
Credentialing and enrollment lapses
Expired enrollments and missing ERA/EFT setup stall payments.
What we doCredentialing and ERA/EFT
Enrollments, re-credentialing and maintenance filings kept current.
Billing & RCM services
Choose full revenue cycle management or start with the area that needs the most attention.
Payment posting
Every payment and adjustment accounted for.
- ERA and EOB posting
- Underpayment identification
- Patient balance follow-through
Denial management & appeals
Denials corrected, resubmitted or appealed.
- Worked within 3 business days
- Appeal letters and documentation
- Denial trend and root-cause tracking
AR follow-up & high-dollar recovery
Aged balances worked by priority and deadline.
- Aged claims and underpayments
- Documentation gap resolution
- Timely filing deadline tracking
Prior authorization
Authorizations secured before the visit.
- Submissions and pre-certification
- Status tracking and escalations
- Renewals and visit-limit tracking
Eligibility & insurance verification
Coverage confirmed before patients arrive.
- Daily eligibility report on your schedule
- Coordination of benefits checks
- Coverage issues flagged early
Credentialing & ERA/EFT enrollment
Providers enrolled and payments flowing.
- Payer credentialing applications
- ERA and EFT enrollment
- Re-credentialing and maintenance filings
Virtual front desk
Calls and requests handled for your providers.
- Appointment scheduling
- Patient questions and medication requests routed
- Responses within 24 hours
Reporting & monthly reviews
Clear numbers and a standing meeting.
- AR, denial and collection reports
- Weekly problem list
- Monthly review with your billing manager
Specialties we support
We focus on specialties where authorizations, high-cost claims and aged balances make the biggest difference to collections.
Imaging & Radiology
01- Prior authorizations
- Medical-necessity denials
- High-cost claims
- AR follow-up
Dialysis & Specialty Clinics
02- Eligibility
- Recurring claims
- Coordination of benefits
- Denial management
Behavioral Health & TMS
03- Treatment authorizations
- Visit limits
- Documentation
- Claim follow-up
Ambulatory Surgery Centers
04- Pre-service authorization
- High-dollar claims
- Out-of-network workflows
Emergency Physician Groups
05- High-volume claim follow-up
- Payer issues
- AR projects
Your billing team
Your claims are not dropped into a shared queue. Every client gets dedicated specialists, backed by a billing manager who owns the relationship.
Production Specialist
DedicatedDaily claim submission and reconciliation.
AR & Denial Specialist
DedicatedDenials, appeals and accounts receivable follow-up.
Billing Manager
OversightYour main contact. Audits, reporting, compliance and monthly meetings.
Credentialing Specialist
SupportCredentialing, ERA/EFT enrollment and maintenance filings.
Onboarding
Before we take over your billing, we audit where things stand today so you know exactly what we will fix first.
- Week 1–201
Discovery and agreement
We learn your practice, confirm scope and fee tier, and agree on system access terms.
Agreement signed
- Week 302
Onboarding and access
Onboarding meeting, client checklist and access to your EHR or billing system. A temporary user lets us start sooner.
System access in place
- Week 403
Billing audit and credentialing review
AR, denial and production audits, plus a review of the payers you are contracted with. We present the findings and the reports you will receive.
Audit and plan presented
- Week 504
Go-live
A go-live meeting brings the audit findings and plan together, and your billing operations move to our team.
Billing operations live
After go-live: monthly progress meetings for the first three months, then a meeting schedule that suits you.
Reporting
Reports on a fixed schedule, explained to you before go-live, so there are no surprises.
Daily
- Advanced eligibility report for the day’s schedule
Weekly
- Problem list of claims and accounts that need your input
Monthly
- AR, denial and collection reports
- AR aging by bucket
- Revenue cycle summary
- Monthly progress meeting
- 0–3046%
- 31–6022%
- 61–9014%
- 91–1209%
- 120+9%
Every bucket reviewed with you monthly. Figures shown are illustrative.
The same agenda every month.
Your billing manager walks through the numbers that matter and the open items that need a decision from your team.
- Production trends
- How quickly charges are submitted after the visit.
- Clean claim rate
- Share of claims accepted on first submission.
- Denial ratio
- Percentage of claims denied, with the reasons.
- Open problem list
- Items still waiting on information or action.
- Accounts receivable trends
- Number of claims and amount pending in each aging bucket.30+ days60+ days90+ days120+ days
Billing + care coordination
When we also manage your care coordination program, our care and billing teams work from the same patient list.
- Documentation gaps are caught before claims go out, which helps lower denials
- Eligible patients are identified for CCM, PCM and RPM programs
- One point of contact for clinical operations and revenue
Pricing
Billing is priced as a percentage of what we collect for you, so our incentives match yours.
Credentialing & ERA/EFT
$50per request
Each credentialing application or ERA/EFT enrollment request.
- New payer credentialing
- ERA and EFT enrollment
- Re-credentialing and maintenance filings
Billing & RCM
4.5%of monthly collections
| Under $100,000 / month | 4.5% |
|---|---|
| $100,000 to $550,000 / month | 4% |
| Above $550,000 / month | Custom |
- Claim submission and payment posting
- Denials, appeals and AR follow-up
- Dedicated production and AR/denial specialists
- Daily, weekly and monthly reporting
- Onboarding audit and monthly reviews
Virtual front desk
$700–$1,000per provider / month
A trained agent handling your patient calls and requests.
- Appointment scheduling
- Patient questions and medication requests
- Billing questions routed to your billing team
Final pricing is confirmed in your agreement after the billing assessment. See engagement models for how other services are priced.
HIPAA & data security
Safeguards and agreements are in place before we access any system that holds patient information.
BAA before access
A Business Associate Agreement and written access terms in every client agreement.
Your systems, your control
We work in your billing software under your authorization, with individual, role-based accounts.
Audit trails
Access controls and activity records that your compliance lead can review.
Trained staff
HIPAA training for every team member and documented processes for each client.
Clinical documentation and final coding decisions stay with your providers. We review, flag and follow up. Your licensed professionals decide.
FAQ
If yours isn’t here, the billing assessment is the place to ask it.
No. We work inside your existing EHR or billing system, under your authorization.
As a percentage of monthly collections: 4.5% under $100,000, 4% from $100,000 to $550,000, and custom pricing above that.
A 5-week onboarding that includes AR, denial and production audits and a credentialing review, all presented to you before go-live.
Your billing manager is your main contact and leads the monthly progress meetings. Your specialists are assigned by name.
Yes. Aged claims, underpayments and high-dollar balances are prioritized and worked against payer deadlines.
Yes. Credentialing and ERA/EFT enrollment are $50 per request, including re-credentialing and maintenance filings.
Yes. A Business Associate Agreement is signed before we access any system with patient information.
A daily eligibility report, a weekly problem list, and monthly AR, denial and collection reports.
Get started
Request a billing assessment. We review your AR, denials and production, show you where revenue is slipping, and explain what we would change.
- Review of your AR aging and largest open balances
- Your top denial reasons and how to prevent them
- A clear quote based on your monthly collections
Mon to Fri, U.S. business hours. Prefer to talk first? Choose a time.